Association of insulin sensitivity to lipids across the lifespan in people with Type 1 diabetes
Article first published online: 11 JAN 2011
© 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK
Volume 28, Issue 2, pages 148–155, February 2011
How to Cite
Maahs, D. M., Nadeau, K., Snell-Bergeon, J. K., Schauer, I., Bergman, B., West, N. A., Rewers, M., Daniels, S. R., Ogden, L. G., Hamman, R. F. and Dabelea, D. (2011), Association of insulin sensitivity to lipids across the lifespan in people with Type 1 diabetes. Diabetic Medicine, 28: 148–155. doi: 10.1111/j.1464-5491.2010.03143.x
- Issue published online: 11 JAN 2011
- Article first published online: 11 JAN 2011
- Accepted manuscript online: 27 SEP 2010 11:31AM EST
- Accepted 16 August 2010
- insulin resistance;
- insulin sensitivity;
- Type 1 diabetes
Diabet. Med. 28, 148–155 (2011)
Aims Insulin resistance and dyslipidaemia both increase cardiovascular risk in Type 1 diabetes. However, little data exist on the associations of insulin resistance to lipids in Type 1 diabetes. Our objective was to explore the associations between insulin resistance (assessed by glucose infusion rate) and lipids in people with Type 1 diabetes and determine whether adiposity and/or average glycaemia influence these associations.
Methods Hyperinsulinaemic–euglycaemic clamp studies were performed in 60 subjects with Type 1 diabetes aged 12–19 years (age 15 ± 2 years, 57% female, duration of diabetes 6.3 ± 3.8 years, HbA1c 8.6 ± 1.5%, IFCC = 70 mmol/mol) and 40 subjects with Type 1 diabetes aged 27–61 years (age 45 ± 9 years, 53% female, duration of diabetes 23 ± 8 years, HbA1c 7.5 ± 0.9%, IFCC = 58 mmol/mol). Multiple linear regression models were fit to examine the association between glucose infusion rate and fasting lipid levels with adjustment for possible confounders.
Results Lower glucose infusion rate was significantly associated with lower levels of HDL cholesterol in youths with Type 1 diabetes and with higher levels of triglycerides and higher triglyceride/HDL ratio in both youths and adults. The magnitude of the associations between glucose infusion rate and lipid levels translate into interquartile differences of 0.098 mmol/l for HDL cholesterol, 0.17 mmol/l for triglycerides and 1.06 for triglycerides/HDL in the adolescents and 0.20 mmol/l for triglycerides and 1.01 for triglycerides/HDL in the adults. The associations were attenuated and no longer statistically significant by adjustment for adiposity among adults, while adjustment for HbA1c had a small effect in youths and adults.
Conclusions Lower insulin sensitivity is associated with a more atherogenic lipid profile in both youths and adults with Type 1 diabetes.